Lebanon's crisis increases the hardships of a neglected society
Residents of Wadi Khaled are confused between feeding their children or taking them to the doctor
Patients do not reach care centers because they do not have enough money to move around or buy medicine.
From the source
Mothers cannot reach care centers because they are far from their place of residence.
From the source
Most children in Wadi Khaled suffer from malnutrition.
From the source
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As the hardships of neglected communities in Lebanon increase due to the crisis, MSF is working to ensure routine vaccination for children in the Wadi Khaled area, which reflects one of the lowest rates of immunization in the country.
“The truth is that I have to choose between feeding my children or taking them to the doctor,” Ahed says, holding her one-year-old baby tightly for fear of hurting himself on the open porch of their unfinished home.
Ahed and her family live in Wadi Khaled, one of the poorest and most neglected areas in the Akkar Governorate in northern Lebanon, on the border with western central Syria.
This family is one of many families in Wadi Khaled that, long before the crisis in Lebanon worsened, were barely able to secure the necessities of living, and as a result of the deteriorating situation they are now forced to meet basic needs at the expense of others.
Ahed says: "My husband sometimes works in agricultural lands, and our income barely covers our basic needs such as food, water, and electricity."
Ahed adds: “You feel very helpless because of your inability to provide the basic necessities for your children, knowing that a single dose of the vaccine can provide long-term prevention of disease for my child.”
Lebanon has always included out-of-sight communities struggling to secure a living, located in semi-ruined suburbs, and remote villages, amid the embodiment of Lebanon's image of luxury.
This is far from reality and the current public discourse amid the country's crisis.
The residents of Wadi Khaled are descended from Bedouin roots and a tribal identity that they continue to maintain until today. They did not obtain Lebanese citizenship until the late nineties, due to historical and political events during the period of the establishment of the Greater Lebanon State in 1920. Still, about 1,600 residents in the region do not own Now the nationality.
This community depends mainly on agriculture, as well as trade between Lebanon and Syria.
Ahed says: “In the best cases, the monthly income of our family can reach about 350 thousand Lebanese pounds, which is equivalent to 24 dollars today due to the devaluation of the currency.
I will draw you a clearer picture. The price of a loaf of bread today is 13,000 Lebanese pounds, and this price is constantly rising.
Previously, 10,000 Lebanese pounds was enough to secure three meals.
Today, it can hardly be enough to buy one meal.
That is why my children often sleep on an empty stomach.”
Choosing food over health care
The growing needs of communities in Lebanon have prompted people to prioritize the purchase of food, over access to health care, in a country where the privatization of medical care is highly prevalent.
To avoid spending money, many people delay seeking care until their health has deteriorated to a critical point.
At this point, it is too late to take preventive care measures, and the need for hospital treatment is urgent.
“With the increase in the proportion of Lebanese poor, communities living on the edge of poverty are more likely to neglect preventive care, or try to treat diseases on their own,” says Marcelo Fernandez, MSF's head of mission in Lebanon.
Fernandez adds, "What we are witnessing in Wadi Khaled is a vivid example of that, and people in fragile conditions are the most affected."
Limited access to care
Wadi Khaled, which covers an area of 40 square kilometers and includes more than 22 villages, has limited access to basic health care.
It lacks basic public health care centers, and people have to travel about 40 kilometers to reach a public hospital.
Moreover, people suffer from other obstacles including the cost of transportation, which continues to rise.
Routine vaccination program
One of the most concrete examples of the health situation in Wadi Khaled comes from looking at the number of children who have not received routine vaccination, which is very worrying in a country that suffers from regular outbreaks of measles and is still struggling to ensure that no polio cases emerge.
In this regard, Rana Hammoud, a nurse working in the Doctors Without Borders clinic, says: “There are no official figures about the immunization coverage rate in Wadi Khaled.
However, the number of children arriving at our clinic without receiving the hepatitis B vaccine at birth indicates a low coverage rate for routine vaccination in the region.”
As part of MSF's delivery of basic healthcare activities in Wadi Khaled, medical teams support the MoPH immunization program by providing routine vaccination.
Since 2021, WHO has succeeded in fully vaccinating more than 5,000 children.
Ahed says: “Thanks to Doctors Without Borders, my children were able to complete the routine vaccination programme.
Although local or international humanitarian organizations run the few health facilities available in the area, most of them do not provide health care on a regular basis.”
She continues: “The difficulty lies not only in the absence of many health facilities, but also in their remoteness.
The transportation costs are very high, I need 10,000 Lebanese pounds every time I visit the clinic, which is something that people cannot afford here.”
To help solve the problem of transportation costs and facilitate access to routine vaccinations, doctors visit villages throughout Wadi Khaled, conducting weekly vaccination campaigns.
The medical teams for health awareness also organize weekly health awareness sessions in order to counter misconceptions and encourage people to receive routine vaccination.
Wadi Khaled is an example of the health situation in Lebanon
Vaccination is one of the basic medical services that the Lebanese are forced to abandon, due to the absence of a system to provide health services in an appropriate manner, especially in the neglected Lebanese regions.
This situation is getting worse with the exacerbation of the Lebanese crisis.
Since 2020, studies have reported that Lebanon's use of routine vaccination has decreased by 31% at the national level.
This is due to the COVID-19 outbreak, transportation cost barriers and a lack of vaccinations in the private sector, as Lebanon struggles to import medical supplies and medicines.
"We have two realities here," Fernandez says.
First, the increase in the number of people hospitalized in cases that could have been avoided through preventive care will put additional pressure on the collapsing health system.
Second, although patients have managed to avoid paying costs for some time by delaying access to medical care, they will eventually find themselves having to pay hospitalization fees in a country where most people cannot afford private health insurance, let alone the National Insurance Fund The health system is disintegrating due to the current conditions in Lebanon.
• Since 2020, studies have reported that Lebanon's use of routine vaccination has decreased by 31% at the national level. The reason for this is due to the lockdown measures related to the outbreak of “Covid-19”, transportation cost barriers and a lack of vaccinations in the private sector, as Lebanon struggles to import medical supplies and medicines.
• Wadi Khaled, which covers an area of 40 square kilometers and includes more than 22 villages, has limited access to basic health care. It lacks basic public health care centers, and people have to travel about 40 kilometers to reach a public hospital.
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